I think we saw this same story in Sicko, almost the exact same story so must be more of this going around with irregular periods now being a basis for denying insurance coverage. Another woman was turned down due to "history of infertility" as she had taken a fertility drug. How do you win on that one, go figure, so women who will have expenses related to childbirth are a better risk? What’s up with this?
What is really bad is the fact that they will insure you, take your premiums, and then when the bills comes in, cherry pick and find a reason not to pay and nicely reimburse your premium payments, which of course are a drop in the bucket normally compared to what the cost of surgery or the procedure is.
Anybody ever hear of "predictive modeling"? It is a computerized algorithm to see if your anticipated medical bills will out weigh what you pay on premiums, based on input of your current medications, treatments, etc. Gosh, with all of this and more being added to our charts, it’s amazing that anybody will qualify soon as almost 80% of the population has some kind of chronic condition. How did this all get started:
“During the Great Depression, hospitals suddenly found themselves full of patients too poor to pay their bills. So they began offering insurance policies based on a simple principle: Everybody pays a modest premium, so there is enough money to cover the large medical bills of the small minority of the population with serious health problems. If, heaven forbid, you got sick, you were covered, and hospitals stayed in business. But commercial insurers, who joined the game in the 1950s, had another obligation: pleasing shareholders. The simplest way to make money was to try to attract healthy customers, who were less likely to rack up big medical bills.”
Not too long ago I posted about marrying for Insurance, divorcing for Medicaid, so it does make one wonder what are we doing today. One thing for sure is that the insurance companies are all running to the new frontier in China, no wonder a single payer health plan is looking better all the time. BD
But four months after Ruess's medical crisis passed, she faced a financial one. The Insurers Administrative Corporation (IAC), the company in Phoenix that managed Ruess's health care policy, completed what it says was a routine review of her records and discovered what it called evidence of a preexisting gynecological condition.
Ruess was flabbergasted. "I was — please forgive me for lack of a better term — pissed off," she says. What IAC called a preexisting condition was a one-time notation in her file regarding "dysfunctional uterine bleeding" — that is, irregular periods, a common issue that at some point affects between 10 percent and 30 percent of women in their reproductive years. At the time she experienced erratic periods, Ruess had lost her husband and her father had died, too, which is why her doctor attributed the symptom to stress.
A woman might not realize she is uninsurable until she needs coverage and finds that no one will sell her a policy. Or she might be hit with this information after months or years of dutifully paying premiums, when filing a major claim provokes the insurer to review her records. Such practices are not only legal but, from the standpoint of the insurance companies, also entirely logical: They are good for business.
When you are denied health insurance - Health care- msnbc.com